Buprenorphine's Effect on the Human Immune System and Inflammation

• Published in: Clinical and translational science Vol. 18; no. 3; pp. e70180 - n/a
• Main Authors: Shin, Samuel D., Branning, Rachel, McGinnis, Michele, Shin, Alexandra, Ho, Ming‐Fen, Karpyak, Victor M., Oesterle, Tyler
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.03.2025; John Wiley and Sons Inc; Wiley
• Subjects: Analgesics, Opioid - adverse effects; Analgesics, Opioid - pharmacology; Brain - drug effects; Brain - immunology; Buprenorphine; Buprenorphine - adverse effects; Buprenorphine - pharmacology; Buprenorphine - therapeutic use; Citation indexes; Clinical trials; Dopamine; Drug abuse; Drug addiction; Heroin; Histamine; Human subjects; Humans; Immune system; Immune System - drug effects; Immune System - immunology; Inflammation; Inflammation - drug therapy; Inflammation - immunology; Librarians; Methadone; Narcotics; Neuroimaging; Opiate Substitution Treatment - methods; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - immunology; Opioids; Pathogenesis; Reviews; Search engines; Search strategies; Substance use disorder; Systematic Review; United States > US; immune system; inflammation; buprenorphine
• ISSN: 1752-8054; 1752-8062; 1752-8062
• DOI: 10.1111/cts.70180

ABSTRACT Opioid use disorder is a persistent epidemic despite several FDA‐approved medications for its treatment. While the pathogenesis of opioid use disorder has been classically attributed to dopamine pathways in the brain, there is emerging evidence and interest surrounding the role of inflammation and inflammatory signaling in its development and treatment. Buprenorphine has become the most prescribed medication for opioid use disorder, largely due to its ease of access and tolerability. This review aimed to better characterize contemporary knowledge of how buprenorphine modulates the human immune system and inflammatory functions in this population. A comprehensive review was conducted using 11 key databases, including Embase, MEDLINE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. This review captured 8177 records, and 14 studies were ultimately selected for inclusion and discussion in this review. Notably, all 14 clinical studies evaluated buprenorphine's effect on the peripheral immune system, and the majority of the studies supported the notion that initiation and maintenance of buprenorphine restore immune suppression caused by opioid use disorder. In addition, we discuss how recent and ongoing work utilizing advanced imaging and cellular technologies is advancing the understanding of how buprenorphine affects the immune and inflammatory signaling in the brain.